补肾法治疗小儿支气管哮喘缓解期的Meta分析

Meta-analysis of kidney-tonifying therapy for infantile bronchial asthma in remission period

目的对补肾法治疗支气管哮喘缓解期患儿进行疗效及安全性评价。方法计算机检索Cochrane Library、Embase、PubMed、CBM、CNKI、维普、万方数据库中关于补肾法治疗小儿支气管哮喘缓解期的随机对照试验,使用RevMan 5.3软件对纳入文献进行质量评价与Meta分析。结果最终纳入13项随机对照试验,共1182例患者,试验组591例,对照组591例。Meta分析结果示:补肾法治疗小儿支气管哮喘可提高临床疗效[Z=6.14,OR=4.75,95%CI(2.89,7.81),P<0.00001];肺功能呼气峰流速值水平[Z=3.61,MD=0.63,95%CI(0.29,0.97),P=0.0003];肺功能第一秒用力肺活量水平[Z=4.08,MD=0.21,95%CI(0.11,0.31),P<0.0001];血清IgA水平[Z=6.82,MD=0.22,95%CI(0.16,0.29),P<0.00001];血清IgG水平[Z=11.88,MD=1.71,95%CI(1.43,1.99),P<0.00001];血清IgM水平[Z=4.70,MD=0.18,95%CI(0.11,0.26),P<0.00001];炎性因子IgE水平[Z=5.39,MD=-28.13,95%CI(-38.36,-17.90),P<0.00001];炎性因子白细胞介素-4水平[Z=15.22,MD=-5.33,95%CI(-6.02,-4.64),P<0.00001];炎性因子γ干扰素水平[Z=6.62,MD=1.69,95%CI(1.19,2.19),P<0.00001]。3项研究明确提出无明显不良反应发生,其余文献未提及。结论现有数据表明补肾法治疗小儿哮喘缓解期在提高肺功能水平,提高血清IgA、IgG、IgM,降低炎性因子IgE水平,调节白细胞介素-4/γ干扰素水平上疗效较好。

Objective To evaluate the efficacy and safety of kidney-tonifying in the treatment of bronchial asthma in children in remission period.Methods Cochrane Library,Embase,PubMed,CBM,CNKI,Weipu and Wanfang databases were searched through computers for randomized controlled trials(RCTs)on the treatment of childhood bronchial asthma in remission period,and RevMan 5.3 software was used to evaluate the quality of the included literatures and Meta analysis was made.Results Totally 13 RCTs were finally included,with a total of 1182 patients,591 in the experimental group and 591 in the control group.Meta-analysis results showed that kidney-tonifying therapy for bronchial asthma in children could improve the clinical efficacy[Z=6.14,OR=4.75,95%CI(2.89,7.81),P<0.00001];the level of peak expiratory flow rate(PEF)of lung function[Z=3.61,MD=0.63,95%CI(0.29,0.97),P=0.0003];forced vital capacity(FEV1)level in the first second of lung function[Z=4.08,MD=0.21,95%CI(0.11,0.31),P<0.0001];Serum IgA level[Z=6.82,MD=0.22,95%CI(0.16,0.29),P<0.00001];Serum IgG level[Z=11.88,MD=1.71,95%CI(1.43,1.99),P<0.00001];Serum IgM level[Z=4.70,MD=0.18,95%CI(0.11,0.26),P<0.00001];Inflammatory factor IgE level[Z=5.39,MD=-28.13,95%CI(-38.36,-17.90),P<0.00001];the level of inflammatory factor IL-4[Z=15.22,MD=-5.33,95%CI(-6.02,-4.64),P<0.00001];the level of inflammatory factor IFN-γ[Z=6.62,MD=1.69,95%CI(1.19,2.19),P<0.00001].Three studies clearly showed that no obvious adverse reactions occurred,and the rest of the literatures did not mention it.Conclusion Existing data show that the Kidney-tonifying therapy in the treatment of infantile asthma in the remission period is effective in improving the level of lung function,increasing the serum IgA,IgG,IgM,reducing the level of inflammatory factors IgE,and regulating the level of IL-4/IFN-γ.